1
|
Singh A, Hegde S, Silva M, Whelan M, Karahalios A, Manton DJ, Goldfeld S, English DR, Dashper S. Social inequities in early childhood caries in Australia: A population-based study on statewide public dental services data. Int J Paediatr Dent 2024. [PMID: 38816920 DOI: 10.1111/ipd.13219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 05/01/2024] [Accepted: 05/20/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Social disadvantage leads to dental caries during childhood. AIM This study investigated whether dental caries occur earlier in children from households experiencing social disadvantage than those not experiencing social disadvantage. DESIGN The overall risk of, and relative time to, early childhood caries (ECC) according to sociodemographic characteristics in Victoria, Australia, was quantified. Records for 134 463 children in Victoria, Australia, from 2009 to 2019 were analysed. Time ratios (TR) and hazard ratios (HR) of carious lesion(s) in early childhood were estimated. RESULTS Compared with reference groups, Indigenous children had an adjusted TR of 0.80 (95% CI: 0.78, 0.82), children from households with languages other than English had an adjusted TR of 0.83 (95% CI: 0.82, 0.84), and dependants of concession cardholders had an adjusted TR of 0.81 (95% CI: 0.80, 0.81); therefore, 20%, 17% and 19% reduced times to the first carious lesion, respectively. The estimated HRs were 1.57 (95% CI: 1.49, 1.67) for Indigenous children, 1.46 (95% CI: 1.42, 1.50) for children from households with other languages and 1.57 (CI: 1.53, 1.60) for dependants of concession cardholders. CONCLUSION Preventive oral health interventions must be targeted early in children from households experiencing social disadvantage to avoid social inequities in ECC.
Collapse
Affiliation(s)
- Ankur Singh
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Shalika Hegde
- Dental Health Services Victoria, Melbourne, Victoria, Australia
| | - Mihiri Silva
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
- Inflammatory Origins, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Dentistry, Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
| | - Martin Whelan
- Dental Health Services Victoria, Melbourne, Victoria, Australia
| | - Amalia Karahalios
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - David J Manton
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
- Centrum voor Tandheelkunde en Mondzorgkunde, University Medical Center Groningen, Groningen, The Netherlands
| | - Sharon Goldfeld
- Department of Paediatrics, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Dallas R English
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Stuart Dashper
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
2
|
Folayan MO, Coelho EMRDB, Ayouni I, Nguweneza A, Al-Batayneh OB, Daryanavard H, Duangthip D, Sun IG, Arheiam A, Virtanen JI, Gaffar B, El Tantawi M, Schroth RJ, Feldens CA. Association between early childhood caries and parental education and the link to the sustainable development goal 4: a scoping review. BMC Oral Health 2024; 24:517. [PMID: 38698356 PMCID: PMC11064360 DOI: 10.1186/s12903-024-04291-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 04/24/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND The goal of the United Nations Sustainable Development Goal (SDG) 4 is to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. The aim of this scoping review was to map the current evidence on the association between the prevalence of early childhood caries (ECC) and parental education; and to identify possible pathways by which parental education may protect against ECC. METHODS The two questions that guided this review were: what is the existing evidence on the association between maternal and paternal education and ECC; and what are the pathways by which parental education protects against ECC? The initial search was conducted in January 2023 in PubMed, Web of Science and Scopus. Articles published in English between January 2000 and October 2022 that reported on the association between parental education and ECC were screened, and the extracted data were compiled, summarized, and synthesized. Review papers and non-primary quantitative research papers were excluded from the full-text review. Open coding was applied to develop a conceptual framework. RESULTS In total, 49 studies were included: 42 cross-sectional, 3 case-control and 4 cohort studies. The majority (91.8%) reported on the associations between ECC and maternal (n = 33), paternal (n = 3), and parental (n = 9) level of education, and 13 (26.7%) reported on the association between parental education and the severity of ECC. Mothers with more than primary school education (n = 3), post-secondary/college/tertiary education (n = 23), and more than 4-12 years of education (n = 12) had children with lower risk for ECC. Two studies reporting on parental education found an association between maternal but not paternal education and ECC. The review suggests that achieving the SDG 4.1 may reduce the risk of ECC. Possible pathways by which maternal education protects from ECC were feeding practices, oral hygiene practices, and the use of dental services. CONCLUSION The study findings suggests that higher maternal educational level may reduce the risk for the consumption of cariogenic diet, poor oral hygiene practices and poor use of dental services for caries prevention. However, the association between paternal education and ECC was not consistently observed, with significant associations less frequently reported compared to maternal education. Future studies are needed to define the magnitude and modifiers of the impact of maternal education on the risk for ECC.
Collapse
Affiliation(s)
- Morenike Oluwatoyin Folayan
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada.
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - Elisa Maria Rosa de Barros Coelho
- Department of Pediatric Dentistry, Lutheran University of Brazil, Canoas, Brazil
- Department of Pediatric Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Imen Ayouni
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Arthemon Nguweneza
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Ola Barakat Al-Batayneh
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Preventive Dentistry Department, Jordan University of Science and Technology, Irbid, Jordan
| | - Hamideh Daryanavard
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Dubai Health Authority, Dubai, United Arab Emirates
| | - Duangporn Duangthip
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Ivy Guofang Sun
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Arheiam Arheiam
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Community and Preventive Dentistry, University of Benghazi, Benghazi, Libya
| | - Jorma I Virtanen
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Balgis Gaffar
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Maha El Tantawi
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Robert J Schroth
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, Canada
| | - Carlos Alberto Feldens
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Pediatric Dentistry, Lutheran University of Brazil, Canoas, Brazil
| |
Collapse
|
3
|
Shrestha SK, Arora A, Manohar N, Ekanayake K, Foster J. Association of Breastfeeding and Early Childhood Caries: A Systematic Review and Meta-Analysis. Nutrients 2024; 16:1355. [PMID: 38732602 PMCID: PMC11085424 DOI: 10.3390/nu16091355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/19/2024] [Accepted: 04/20/2024] [Indexed: 05/13/2024] Open
Abstract
Early childhood caries (ECC) is a growing public health concern worldwide. Although numerous systematic reviews have been published regarding the association between breastfeeding and early childhood caries (ECC), the results remain inconclusive and equivocal. This systematic review synthesises the evidence on the association between breastfeeding and ECC. Five electronic databases and backward citation chasing were performed from inception until May 2023. A total of 31 studies (22 cohort studies and 9 case-control studies) were included in this review. The meta-analysis of the case-control studies showed statistically significant fewer dental caries in children who were breastfed for < 6 months compared to those who were breastfed for ≥6 months (OR = 0.53, 95% CI 0.41-0.67, p < 0.001). There was a statistically significant difference in dental caries between children who were breastfed for <12 months and those who were breastfed for ≥12 months (RR = 0.65, 95% CI 0.50-0.86, p < 0.002). Similarly, there was a statistically significant difference in dental caries in children who were breastfed for < 18 months compared to those who were breastfed for ≥18 months (RR = 0.41, 95% CI 0.18-0.92, p = 0.030). Nocturnal breastfeeding increases the risk of ECC compared with no nocturnal breastfeeding (RR = 2.35, 95% CI 1.42-3.89, p < 0.001). The findings suggest breastfeeding for more than 12 months and nocturnal breastfeeding increase the risk of ECC.
Collapse
Affiliation(s)
- Sheetal Kiran Shrestha
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia
- Discipline of Child and Adolescent Health, The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW 2010, Australia
| | - Narendar Manohar
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia
- Blackdog Institute, Hospital Road, Randwick, NSW 2031, Australia
| | - Kanchana Ekanayake
- University of Sydney Library, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Jann Foster
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- School of Nursing and Midwifery, University of Canberra, Bruce, ACT 2617, Australia
- Ingham Research Institute, Liverpool, NSW 2170, Australia
| |
Collapse
|
4
|
Sandy L, Helmyati S, Amalia R. Nutritional factors associated with early childhood caries: A systematic review and meta-analysis. Saudi Dent J 2024; 36:413-419. [PMID: 38525179 PMCID: PMC10960096 DOI: 10.1016/j.sdentj.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/26/2023] [Accepted: 12/06/2023] [Indexed: 03/26/2024] Open
Abstract
Background Many studies have examined the relationship between nutrition and dental caries. However further studies are needed regarding nutritional factors that can have a strong impact on the incidence of early childhood caries (ECC). Nutrition is one factor that determines caries occurrence. Exposure to carbohydrates in the oral cavity causes carbohydrate fermentation, which produces acids. This acidic substance erodes the enamel surface of teeth, leading to ECC. This systematic review and meta-analysis of cohort studies assessed the aspects of nutrition and diet that contribute to the incidence of ECC in children. Materials and methods We conducted a systematic review by extracting data according to Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. A search was conducted of published articles in Scopus, MEDLINE via PubMed, and Science Direct using the keywords "nutrition," "sugar," "carbohydrate," "dietary habit," "dental caries," and "oral health." The protocol was registered at PROSPERO 2023 (Registration ID: CRD42023394583). Results The article screening yielded 6 articles that met the inclusion criteria. From the total of 443 studies found. Those that could not determine a correlation between the ECC variables and nutrition and with data analyses that only used a bivariate analysis were excluded. The results of the meta-analysis showed that nutritional factors had the strongest impact on caries including feeding practice (OR 3.64; 95% CI 2.03, 6.55), sugar intake (OR 3.24; 95% CI 2.59, 4.03), and low fruit and vegetable intake (OR 2.71; 95% CI 1.47, 5.01). Conclusion Two nutritional factors had the strongest relationship with the risk of ECC: feeding practice and sugar intake. The lowest risk factor for causing ECC was low fruit and vegetable intake.
Collapse
Affiliation(s)
- L.P.A. Sandy
- Doctorate Program of Medical and Health Science, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada Yogyakarta Indonesia, 55281, Indonesia
| | - S. Helmyati
- Department of Nutrition and Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada Yogyakarta Indonesia, 55281, Indonesia
- Center for Health and Human Nutrition, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada Yogyakarta Indonesia, 55281 Indonesia, Indonesia
| | - R. Amalia
- Department Dental Public Health, Faculty of Dentistry, Universitas Gadjah Mada Yogyakarta Indonesia, 55281, Indonesia
| |
Collapse
|
5
|
Tantipoj C, Powattanasuk W, Manusrudee S, Buranachad N. Risk Factors of Dental Caries in the Thai Population: The Retrospective Cohort Study. J Int Soc Prev Community Dent 2023; 13:373-379. [PMID: 38124729 PMCID: PMC10729882 DOI: 10.4103/jispcd.jispcd_53_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/26/2023] [Accepted: 08/30/2023] [Indexed: 12/23/2023] Open
Abstract
Aim The aim of this retrospective cohort study was to determine the risk factors associated with the occurrence of dental caries increments in Thai dental patients. Materials and Methods The dental chart records of 500 patients who visited the Department of Advanced General Dentistry, Mahidol University during 2003-2013 were included in this research. Risk factors such as age, gender, medical history, marital status, routine oral checkup, oral appliance usage, initial and final records of decayed (DT)-missing-filled (DMF-T), dental history of tooth extraction due to caries, xerostomia, presence of visible plaque, presence of interproximal restoration, and caries risk level were retrieved from dental records. Cox proportional hazard regression model was used to determine the association of caries risk factors and new dental caries increments. Results The results indicated that the rate of incidence of new dental caries was 2.1 per 100 person-month. In the multivariate hazard model, past caries experience in more than three teeth (adjusted hazard ratio: 2.29, 95%CI: 1.53-3.44) and xerostomia (adjusted hazard ratio: 4.47, 95%CI: 1.82-10.98) were independent risk factors of dental caries increments. Other factors, such as demographic data, physical factors, clinical factors, and other contributing factors, were not associated with the incidence of new dental caries. Conclusion The presence of past caries experience and xerostomia were predictors of the occurrence of new dental caries.
Collapse
Affiliation(s)
- Chanita Tantipoj
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Wifada Powattanasuk
- Mahidol International Dental School, Faculty of Dentistry, Mahidol University, Ratchathewi, Bangkok, Thailand
| | | | - Naiyana Buranachad
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Ratchathewi, Bangkok, Thailand
| |
Collapse
|
6
|
Kateeb E, Lim S, Amer S, Ismail A. Behavioral and social determinants of early childhood caries among Palestinian preschoolers in Jerusalem area: a cross-sectional study. BMC Oral Health 2023; 23:152. [PMID: 36922767 PMCID: PMC10015793 DOI: 10.1186/s12903-023-02809-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/13/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND This study came to determine the prevalence of Early Childhood Carries (ECC) among preschoolers in a marginalized population and describe the influence of behavioral and social determinants on the development of ECC. METHODS This is a cross-sectional study that was carried out in four random preschools in the Jerusalem Governorate of the Occupied Palestinian Territories. All children aged 3-5 years old in the selected schools were screened for ECC using the decayed, missing, and filled teeth index (dmft). Data on children's socio-economic, feeding habits, hygiene habits, access to care, parental level of stress, social support, and locus of control were collected by a validated questionnaire sent to the children's main caregivers. Descriptive statistics were generated and bivariable and multivariable analyses were used to explain the influence of different behavioral and social determinants on ECC levels. RESULTS Four hundred and fifty-seven preschoolers completed the questionnaire and the clinical screening. Ninety-seven percent (n = 447) had experienced dental decay, with an average dmft score of 6.6 ± 4.3. After accounting for potential confounding, parents' internal locus of control was associated with lower dental caries among children (IRR = 0.97, 95% CI = 0.97, 0.98). Having routine, preventive visits versus never seeing a dentist were associated with lower dmft scores (IRR = 0.42, 95% CI = 0.33, 0.52). Night feeding habits (putting things other than water in the baby bottle at night, having children sleep while being breastfed at night) were positively associated with children's dental caries (IRR = 1.06, 95% CI = 1.04, 1.09: IRR = 1.15, 95% CI = 1.03, 1.29, respectively). Not adding sugar to the bottle was negatively associated with children's dental caries (IRR = 0.86, 95% CI = 0.74, 1.00). CONCLUSIONS Preschoolers in this study suffered from high dental caries experience. Although infant feeding habits were key factors in explaining the elevated level of the disease, system and socio-psychological factors were also detrimental to ECC prevalence. Policies and interventions to alleviate the burden of ECC need to address socioeconomic determinants of health in addition to feeding and hygiene practices.
Collapse
Affiliation(s)
- Elham Kateeb
- Oral Health Research and Promotion Unit, Al-Quds University, Jerusalem, Palestine.
| | - Sungwoo Lim
- Kornberg School of Dentistry, Temple University, Philadelphia, PA, USA
| | - Saif Amer
- Oral Health Research and Promotion Unit, Al-Quds University, Jerusalem, Palestine
- Horizon Academy, Al-Nayzak, Ramallah, Palestine
| | - Amid Ismail
- Kornberg School of Dentistry, Temple University, Philadelphia, PA, USA
| |
Collapse
|
7
|
Alkhtib AO, Mohamed HG. Current knowledge about early childhood caries in the gulf cooperation council with worldwide reflection: Scoping review of the scientific literature (2010-2021). PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001228. [PMID: 36962836 PMCID: PMC10021236 DOI: 10.1371/journal.pgph.0001228] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 12/19/2022] [Indexed: 01/13/2023]
Abstract
Early childhood caries (ECC) is one of the most prevalent chronic childhood diseases affecting the primary teeth of children younger than 6 years of age. The disease etiology is complex and includes social, biological, and dietary factors. This review aims to explore the knowledge of ECC prevalence globally and locally within the Gulf Cooperation Council (GCC) countries during the years 2010-2021. Another aim is to explore oral health promotion programs with more focus on the GCC region. A search was conducted in PubMed, Medline, Scopus, the Cochrane Collaboration database, and Google Scholar to identify relevant studies published between 2010 and 2021 using specific keywords. Studies that utilized both the World Health Organization criteria and International Caries Detection and Assessment System for dental caries assessment were included. The included studies indicated considerable variation in the reported prevalence of ECC. While developed countries show low prevalence, countries in the GCC and other Arab countries show a high prevalence of ECC. Many oral health promotion programs were identified globally including oral health education, nutritional programs, the use of fluoride and pit-and-fissure sealants, and inter-professional population-based oral health promotion and prevention programs such as school-based oral health programs, motivational interviewing, and anticipatory guidance. ECC remains a significant problem in many parts of the world including the GCC region. Oral health prevention programs have been established within the GCC region. Nevertheless, the GCC region has some unique characteristics that need to be investigated to contextualize the western model of the dynamics of ECC prevention and promotion programs locally.
Collapse
|
8
|
Duque C, Chrisostomo DA, Souza ACA, de Almeida Braga GP, Dos Santos VR, Caiaffa KS, Pereira JA, de Oliveira WC, de Aguiar Ribeiro A, Parisotto TM. Understanding the Predictive Potential of the Oral Microbiome in the Development and Progression of Early Childhood Caries. Curr Pediatr Rev 2023; 19:121-138. [PMID: 35959611 DOI: 10.2174/1573396318666220811124848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 03/24/2022] [Accepted: 04/22/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Early childhood caries (ECC) is the most common chronic disease in young children and a public health problem worldwide. It is characterized by the presence of atypical and fast progressive caries lesions. The aggressive form of ECC, severe early childhood caries (S-ECC), can lead to the destruction of the whole crown of most of the deciduous teeth and cause pain and sepsis, affecting the child's quality of life. Although the multifactorial etiology of ECC is known, including social, environmental, behavioral, and genetic determinants, there is a consensus that this disease is driven by an imbalance between the oral microbiome and host, or dysbiosis, mediated by high sugar consumption and poor oral hygiene. Knowledge of the microbiome in healthy and caries status is crucial for risk monitoring, prevention, and development of therapies to revert dysbiosis and restore oral health. Molecular biology tools, including next-generation sequencing methods and proteomic approaches, have led to the discovery of new species and microbial biomarkers that could reveal potential risk profiles for the development of ECC and new targets for anti-caries therapies. This narrative review summarized some general aspects of ECC, such as definition, epidemiology, and etiology, the influence of oral microbiota in the development and progression of ECC based on the current evidence from genomics, transcriptomic, proteomic, and metabolomic studies and the effect of antimicrobial intervention on oral microbiota associated with ECC. CONCLUSION The evaluation of genetic and proteomic markers represents a promising approach to predict the risk of ECC before its clinical manifestation and plan efficient therapeutic interventions for ECC in its initial stages, avoiding irreversible dental cavitation.
Collapse
Affiliation(s)
- Cristiane Duque
- Department of Preventive and Restorative Dentistry, Araçatuba Dental School, State University of São Paulo (UNESP), Araçatuba, Brazil
| | - Daniela Alvim Chrisostomo
- Department of Preventive and Restorative Dentistry, Araçatuba Dental School, State University of São Paulo (UNESP), Araçatuba, Brazil
| | - Amanda Caselato Andolfatto Souza
- Department of Preventive and Restorative Dentistry, Araçatuba Dental School, State University of São Paulo (UNESP), Araçatuba, Brazil
| | - Gabriela Pacheco de Almeida Braga
- Department of Preventive and Restorative Dentistry, Araçatuba Dental School, State University of São Paulo (UNESP), Araçatuba, Brazil
| | - Vanessa Rodrigues Dos Santos
- Department of Preventive and Restorative Dentistry, Araçatuba Dental School, State University of São Paulo (UNESP), Araçatuba, Brazil
| | - Karina Sampaio Caiaffa
- Department of Preventive and Restorative Dentistry, Araçatuba Dental School, State University of São Paulo (UNESP), Araçatuba, Brazil
| | - Jesse Augusto Pereira
- Department of Preventive and Restorative Dentistry, Araçatuba Dental School, State University of São Paulo (UNESP), Araçatuba, Brazil
| | - Warlley Campos de Oliveira
- Department of Preventive and Restorative Dentistry, Araçatuba Dental School, State University of São Paulo (UNESP), Araçatuba, Brazil
| | - Apoena de Aguiar Ribeiro
- Division of Diagnostic Sciences, University of North Carolina at Chapel Hill - Adams School of Dentistry, Chapel Hill, North Carolina, United State
| | - Thaís Manzano Parisotto
- Laboratory of Clinical and Molecular Microbiology, São Francisco University, Bragança Paulista, Brazil
| |
Collapse
|
9
|
Baltaci E, Ozveren N, Batur Kara S. Social and Behavioural Risk Factors of Early Childhood Caries Among Children Aged 4–47 Months: A Cross-Sectional Study. EURASIAN JOURNAL OF FAMILY MEDICINE 2022. [DOI: 10.33880/ejfm.2022110404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Aim: This study aimed to investigate various risk factors for early childhood caries in a paediatric population in Edirne, Turkey.
Methods: This cross-sectional study included 1197 children aged 4–47 months old who visited family health centres for routine control. Questionnaires were used to collect data on parental- and pediatric-related variables potentially associated with early childhood caries. Oral hygiene was scored using the Visual Plaque Index, and decayed teeth, missing teeth, filled surfaces and carious teeth were recorded. We evaluated risk factors for early childhood caries using a hierarchical regression analysis model.
Results: Of the 1197 children, 219 (18.3%) had dental caries. The mean age of the children in the caries group was 33±7 months old, and the mean filled surfaces and carious teeth values were 4.84±3.49 and 8.50±8.30, respectively. Younger age at the time of first tooth eruption, current height percentile higher than 96, poor oral hygiene, older age, having siblings, and paternal age younger than 30 years old at the time of the child’s birth were associated with an increased risk of early childhood caries.
Conclusion: Prevention policies on caries among young children should focus on the first years of a child's life. Non-dental healthcare professionals may play an important role in being the first contact with parents in the healthcare system for anticipatory guidance.
Keywords: oral health, dental caries, preschool children, risk factors, preventive care
Collapse
Affiliation(s)
- Ezgi Baltaci
- Department of Pediatric Dentistry, Faculty of Dentistry, Trakya University
| | - Neslihan Ozveren
- Department of Pediatric Dentistry, Faculty of Dentistry, Trakya University
| | - Sinem Batur Kara
- Department of Pediatric Dentistry, Faculty of Dentistry, Trakya University
| |
Collapse
|
10
|
Lopez DJ, Hegde S, Whelan M, Dashper S, Tsakos G, Singh A. Trends in social inequalities in early childhood caries using population‐based clinical data. Community Dent Oral Epidemiol 2022. [PMID: 36424707 DOI: 10.1111/cdoe.12816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the longitudinal trends in social inequalities in early childhood caries (ECC) using collected population-based data. METHODS Clinical data on children were routinely collected from 2008 to 2019 in Victoria, Australia. ECC prevalence and severity (dmft) were quantified according to Indigenous status, culturally and linguistically diverse (CALD) status, concession cardholder status, geographic remoteness and area deprivation. The inverse probability weighting was used to quantify social inequalities in ECC. The weighted prevalence differences, and the ratio between the weighted prevalence of ECC and mean dmft and their 95% confidence interval, were then plotted. RESULTS Absolute inequalities in ECC prevalence increased for children by 7% for CALD status and cardholder status between 2008 and 2019. Likewise, absolute inequalities in ECC severity in this time period increased by 0.6 for CALD status and by 0.4 for cardholder status. Relative inequalities in ECC increased by CALD (ratio: 1.3 to 2.0), cardholder status (1.3 to 2.0) and area deprivation (1.1 to 1.3). Relative inequalities in severity increased by CALD (1.5 to 2.8), cardholder (1.4 to 2.5) or area deprivation (1.3 to 1.5). Although children with Indigenous status experienced inequalities in ECC prevalence and severity, these did not increase on the absolute (ECC: 0.1-0.1 Severity: 1.0-0.1) or relative scale (ECC ratio: 1.3-1.3 Severity ratio: 1.6-1.1). CONCLUSIONS Trends in inequalities in ECC were different according to sociodemographic measures. Oral health policies and interventions must be evaluated on the basis of reducing the prevalence of oral diseases and oral health inequalities between population sub-groups.
Collapse
Affiliation(s)
- Diego J. Lopez
- Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health, University of Melbourne Melbourne Victoria Australia
| | - Shalika Hegde
- Dental Health Services Victoria Melbourne Victoria Australia
| | - Martin Whelan
- Dental Health Services Victoria Melbourne Victoria Australia
| | - Stuart Dashper
- Melbourne Dental School University of Melbourne Melbourne Victoria Australia
| | - Georgios Tsakos
- Department of Epidemiology and Public Health University College London London UK
| | - Ankur Singh
- Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health, University of Melbourne Melbourne Victoria Australia
- Melbourne Dental School University of Melbourne Melbourne Victoria Australia
| |
Collapse
|
11
|
The Agency of Difference in Chilean School Policies and Practices: A BioSocioCultural Way-Out Perspective. SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci11070313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In this paper, we explore the active production of difference (as lacking) through the School Vulnerability Index and the School Inclusion Law in Chile. Through a diffractive reading, we present the contradiction between these two policies. While discriminatory knowledge about school subjects is produced in the School Vulnerability Index as truth and common knowledge for the school community, the School Inclusion Law is designed to solve practices of discrimination at school. We contend that, to address issues of segregation in school settings, we have to question the kind of knowledge we need for a more democratic and just future. As a result, we trouble the separation of biological, social, and cultural realms on which instruments are based to continue segregation practices as a natural way to frame inclusion policies in educational contexts. We argue that both policies and instruments play a decisive role in the continuity of a culture of segregation in a neoliberal school tradition.
Collapse
|
12
|
Wu TT, Xiao J, Manning S, Saraithong P, Pattanaporn K, Paster BJ, Chen T, Vasani S, Gilbert C, Zeng Y, Li Y. Multimodal Data Integration Reveals Mode of Delivery and Snack Consumption Outrank Salivary Microbiome in Association With Caries Outcome in Thai Children. Front Cell Infect Microbiol 2022; 12:881899. [PMID: 35677657 PMCID: PMC9168266 DOI: 10.3389/fcimb.2022.881899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/20/2022] [Indexed: 12/22/2022] Open
Abstract
Early childhood caries (ECC) is not only the most common chronic childhood disease but also disproportionately affects underserved populations. Of those, children living in Thailand have been found to have high rates of ECC and severe ECC. Frequently, the cause of ECC is blamed on a handful of cariogenic organisms, such as Streptococcus mutans and Streptococcus sobrinus. However, ECC is a multifactorial disease that results from an ecological shift in the oral cavity from a neutral pH (~7.5) to an acidic pH (<5.5) environment influenced by the host individual’s biological, socio-behavioral, and lifestyle factors. Currently, there is a lack of understanding of how risk factors at various levels influence the oral health of children at risk. We applied a statistical machine learning approach for multimodal data integration (parallel and hierarchical) to identify caries-related multiplatform factors in a large cohort of mother-child dyads living in Chiang Mai, Thailand (N=177). Whole saliva (1 mL) was collected from each individual for DNA extraction and 16S rRNA sequencing. A set of maternal and early childhood factors were included in the data analysis. Significantly, vaginal delivery, preterm birth, and frequent sugary snacking were found to increase the risk for ECC. The salivary microbial diversity was significantly different in children with ECC or without ECC. Results of linear discriminant analysis effect size (LEfSe) analysis of the microbial community demonstrated that S. mutans, Prevotella histicola, and Leptotrichia hongkongensis were significantly enriched in ECC children. Whereas Fusobacterium periodonticum was less abundant among caries-free children, suggesting its potential to be a candidate biomarker for good oral health. Based on the multimodal data integration and statistical machine learning models, the study revealed that the mode of delivery and snack consumption outrank salivary microbiome in predicting ECC in Thai children. The biological and behavioral factors may play significant roles in the microbial pathobiology of ECC and warrant further investigation.
Collapse
Affiliation(s)
- Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, United States
| | - Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, United States
- *Correspondence: Yihong Li, ; Jin Xiao,
| | - Samantha Manning
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, United States
| | - Prakaimuk Saraithong
- Department of Internal Medicine, Division of Infectious Diseases, Medical School University of Michigan, Ann Arbor, MI, United States
| | | | - Bruce J. Paster
- Department of Microbiology, Forsyth Institute, Cambridge, MA, United States
| | - Tsute Chen
- Department of Microbiology, Forsyth Institute, Cambridge, MA, United States
| | - Shruti Vasani
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, United States
| | - Christie Gilbert
- Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY, United States
| | - Yan Zeng
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, United States
| | - Yihong Li
- Department of Public and Ecosystem Health, Cornell University Master of Public Health Program, Ithaca, NY, United States
- *Correspondence: Yihong Li, ; Jin Xiao,
| |
Collapse
|
13
|
Koopaie M, Salamati M, Montazeri R, Davoudi M, Kolahdooz S. Salivary cystatin S levels in children with early childhood caries in comparison with caries-free children; statistical analysis and machine learning. BMC Oral Health 2021; 21:650. [PMID: 34922509 PMCID: PMC8683819 DOI: 10.1186/s12903-021-02016-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 12/07/2021] [Indexed: 01/10/2023] Open
Abstract
Background Early childhood caries is the most common infectious disease in childhood, with a high prevalence in developing countries. The assessment of the variables that influence early childhood caries as well as its pathophysiology leads to improved control of this disease. Cystatin S, as one of the salivary proteins, has an essential role in pellicle formation, tooth re-mineralization, and protection. The present study aims to assess salivary cystatin S levels and demographic data in early childhood caries in comparison with caries-free ones using statistical analysis and machine learning methods. Methods A cross-sectional, case–control study was undertaken on 20 cases of early childhood caries and 20 caries-free children as a control. Unstimulated whole saliva samples were collected by suction. Cystatin S concentrations in samples were determined using human cystatin S ELISA kit. The checklist was collected from participants about demographic characteristics, oral health status, and dietary habits by interviewing parents. Regression and receiver operating characteristic (ROC) curve analysis were done to evaluate the potential role of cystatin S salivary level and demographic using statistical analysis and machine learning. Results The mean value of salivary cystatin S concentration in the early childhood caries group was 191.55 ± 81.90 (ng/ml) and in the caries-free group was 370.06 ± 128.87 (ng/ml). T-test analysis showed a statistically significant difference between early childhood caries and caries-free groups in salivary cystatin S levels (p = 0.032). Investigation of the area under the curve (AUC) and accuracy of the ROC curve revealed that the logistic regression model based on salivary cystatin S levels and birth weight had the most and acceptable potential for discriminating of early childhood caries from caries-free controls. Furthermore, using salivary cystatin S levels enhanced the capability of machine learning methods to differentiate early childhood caries from caries-free controls. Conclusion Salivary cystatin S levels in caries-free children were higher than the children with early childhood caries. Results of the present study suggest that considering clinical examination, demographic and socioeconomic factors, along with the salivary cystatin S levels, could be usefull for early diagnosis ofearly childhood caries in high-risk children; furthermore, cystatin S is a protective factor against dental caries. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-02016-x.
Collapse
Affiliation(s)
- Maryam Koopaie
- Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Salamati
- Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Roshanak Montazeri
- Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, North Kargar St, P.O.BOX:14395 -433, 14399-55991, Tehran, Iran.
| | - Mansour Davoudi
- Department of Computer Science and Engineering and IT, School of Electrical and Computer Engineering, Shiraz University, Shiraz, Iran
| | - Sajad Kolahdooz
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
| |
Collapse
|
14
|
Deghatipour M, Ghorbani Z, Mokhlesi AH, Ghanbari S, Namdari M. Community-based interventions to reduce dental caries among 24-month old children: a pilot study of a field trial. BMC Oral Health 2021; 21:637. [PMID: 34893041 PMCID: PMC8665609 DOI: 10.1186/s12903-021-01999-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 11/30/2021] [Indexed: 11/26/2022] Open
Abstract
Background Early childhood caries (ECC) is the most common dental disease among children worldwide, leading to many difficulties on child’s growth. As WHO mentioned, educational interventions in addition to interprofessional collaboration are needed to achieve proper ECC prevention. In present study we’ve aimed to evaluate the effectiveness of some oral health promotion interventions to reduce dental caries among 24-month old children. Methods A field trial study was conducted amongst 439 mothers from pregnancy up to 24 months after delivery in Public Health Centers in Varamin, Tehran, Iran. Participants were allocated to intervention (n = 239) and control groups (n = 200). Demographic, socioeconomic status and dental care behavior data were collected using a questionnaire. The content of our study intervention consisted of nutritional and behavioral oral health-related messages. Mothers received messages via either of four methods (A: comprehensive method including all other methods together (n = 74), B: group discussion by dentists (n = 59), C: face to face education by primary health care providers (n = 53), and D: social network (n = 53). The control group received routine maternal and oral health care. To assess the effectiveness of interventions on promoting children’s oral health, the oral health-related behaviors data, the number of decayed teeth (d), and being caries free at the age of two were considered. Results Among the 436 examined children, with a mean age of 23.7 months, 48.2% were male. The frequency of using finger toothbrush increased from 53.4% to 89.8% in all intervention groups. The mean (SD) of decayed teeth at 24 months in intervention and control group were 0.36 (0.93) and 1.61 (2.61), respectively. All the four intervention groups, except social network, had more chance of being caries free compared to control group (P value < 0.05). Analysis showed that children in comprehensive intervention group had a higher chance of being caries free compared to all other groups, after adjustment for covariates. Conclusions Performing oral health interventions could help the prevention of dental caries in newborn children. Also, using a combination of different methods of sending messages can have the best results in promoting oral health.
Collapse
Affiliation(s)
- Marzie Deghatipour
- Department of Community Oral Health, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Ghorbani
- Department of Community Oral Health, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Amir Hossein Mokhlesi
- Dental Research Center, Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahla Ghanbari
- Deputy for Health Affairs, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahshid Namdari
- Department of Community Oral Health, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
15
|
Which determinants should be considered to reduce social inequalities in paediatric dental care access? A cross-sectional study in France. PLoS One 2021; 16:e0255360. [PMID: 34347827 PMCID: PMC8336796 DOI: 10.1371/journal.pone.0255360] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/14/2021] [Indexed: 12/03/2022] Open
Abstract
Better access to dental care through systemic and educational strategies is needed to lessen the burden of disease due to severe early caries. Our study aims to describe family characteristics associated with severe early caries: parental knowledge, attitudes, practices in oral health and socio-demographic factors. For this cross-sectional study, 102 parents of children aged under 6 years with severe early caries and attending paediatric dentistry service in France completed a questionnaire during face-to-face interviews. Caries were diagnosed clinically by calibrated investigators, using the American Academy of Paediatric Dentistry criteria, and dental status was recorded using the decayed, missing, and filled teeth index. The majority of children were from underprivileged backgrounds and had poor oral health status, with a median dmft index of 10. Parents highlighted the difficulty of finding suitable dental care in private practices. Parents appeared to have good oral health knowledge and engaged in adapted behaviours but showed a low sense of self-efficacy. They perceived the severity of early caries as important but the susceptibility of their child as moderate. The study affirmed the importance of improving the accessibility of paediatric dental care and developing educational strategies to enhance the knowledge, skills, and oral health practices of families.
Collapse
|
16
|
Sitthisettapong T, Tasanarong P, Phantumvanit P. Strategic Management of Early Childhood Caries in Thailand: A Critical Overview. Front Public Health 2021; 9:664541. [PMID: 34178924 PMCID: PMC8226079 DOI: 10.3389/fpubh.2021.664541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/05/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of this report was to advocate early childhood caries (ECC) and share strategic management in Thailand, despite over two decades of free Universal Health Coverage including oral healthcare. The recent Thai national oral health survey in 2017 indicates the very high prevalence of ECC, with an average of three carious teeth affected in 53% of 3-year-old children. This is despite the efforts of the Ministry of Public Health that has launched several interventional programs ranging from an upstream policy that prohibits sugar additions in baby formula milk to downstream remediations such as advocating and encouraging toothbrushing with fluoride toothpastes. Nevertheless, ECC is strongly predicated by other key factors including the family and community commitment and participation, as embodied in the current World Health Organization guidelines. These encompass three different tiers of community-level prevention: primary, secondary, and tertiary. Accordingly, the following strategies for ECC management in Thailand should be based at primary care clusters (PCC) in sub-district health centers, with the assistance of inter-professional health teams. These include community education on the importance of deciduous teeth and effective toothbrushing with fluoride toothpaste (primary prevention), regular examination and detection of ECC lesions and early intervention (secondary prevention), insertion of non-invasive preventive restorations using cost-effective atraumatic restorative treatment (ART) or simplified and modified ART (SMART) (tertiary prevention), and, finally, effective follow-up and monitoring systems. It is anticipated that this triple tier approach to ECC management will improve not only the oral health but also the overall children's health.
Collapse
|
17
|
Alade M, Folayan MO, El Tantawi M, Oginni AB, Adeniyi AA, Finlayson TL. Early childhood caries: Are maternal psychosocial factors, decision-making ability, and caries status risk indicators for children in a sub-urban Nigerian population? BMC Oral Health 2021; 21:73. [PMID: 33941156 PMCID: PMC8094474 DOI: 10.1186/s12903-020-01324-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/10/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Early childhood caries (ECC) is caries in children below the age of 72 months. The aim of the study was to determine the association of maternal psychosocial factors (general anxiety, dental anxiety, sense of coherence, parenting stress, fatalism, social support, depressive symptoms, and executive dysfunction), decision-making abilities, education, income and caries status with the prevalence and severity of ECC among children resident in Ile-Ife, Nigeria. METHODS A dataset of 1549 mother-child (6-71-months-old) dyads collected through examinations and a household survey, using validated psychometric tools to measure the psychosocial factors, were analyzed. The DMFT for the mothers and the dmft for the child were determined. The association between maternal psychosocial factors, education, income, and decision-making ability, the prevalence of maternal caries, and the prevalence of ECC was determined using logistic regression analysis. RESULTS The prevalence of maternal caries was 3.3%, and the mean (standard deviation-SD) DMFT was 0.10 (0.76). The ECC prevalence was 4.3%, and the mean (SD) dmft was 0.13 (0.92). There was no significant difference between the prevalence and severity of maternal caries and ECC by maternal age, education, income, or decision-making abilities. There was also no significant difference in maternal caries, ECC prevalence and ECC severity by maternal psychosocial factors. The only significant association was between the prevalence of caries in the mother and children: children whose mothers had caries were over six times more likely to have ECC than were children with mothers who had no caries (AOR: 6.67; 95% CI 3.23-13.79; p < 0.001). CONCLUSION The significant association between ECC and maternal caries prevalence suggests that prenatal oral health care for mothers may reduce the risk for ECC.
Collapse
Affiliation(s)
- Michael Alade
- Obafemi Awolowo University Teaching Hospitals’ Complex, Ile-Ife, Nigeria
| | | | - Maha El Tantawi
- Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | | | | | | |
Collapse
|
18
|
Relationship between preterm, low birth weight and early childhood caries: a meta-analysis of the case-control and cross-sectional study. Biosci Rep 2021; 40:225943. [PMID: 32729621 PMCID: PMC7419784 DOI: 10.1042/bsr20200870] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/04/2020] [Accepted: 07/27/2020] [Indexed: 11/17/2022] Open
Abstract
Early childhood caries (ECC) is one of the most prevalent chronic infectious diseases in children. The effective prevention and treatment are heavy burdens and study hotspots for pediatric dentists. Many studies had investigated the relationship between preterm, low birth weight (LBW) and ECC; however, the results were inconsistent. The present study was conducted with an evidence-based study to figure out the relationship between preterm, LBW and ECC for the first time. After searching the database, case–control and cross-sectional studies relevant to the relationship between preterm, LBW and ECC up to December 2019 were included. The data about odds ratio (OR) and 95% confidence interval (95% CI) were extracted and calculated with STATA 14.0 Software. A total of 22 studies were included in this meta-analysis, 9 studies of which did not only explore the relationship between ECC with preterm, but also study the relationship between ECC and LBW, 7 studies of which explored the relationship between preterm and ECC, and 6 studies of which studied the relationship between LBW and ECC. The meta-analysis results showed that the preterm increased the risk of ECC (OR = 1.59, 95% CI: 1.36–1.87) significantly. There was no difference between LBW and normal birth weight in the incidence of ECC (OR = 1.12, 95% CI: 0.94–1.33). The meta-analysis results of adjustment OR about LBW were similar to the crude OR (OR = 1.05, 95% CI: 0.71–1.57). This meta-analysis indicated that preterm increased the risk of ECC significantly; however, LBW was not a risk factor for ECC.
Collapse
|
19
|
Chouchene F, Masmoudi F, Baaziz A, Maatouk F, Ghedira H. Parental stress as a predictor of early childhood caries: a systematic review. Eur Arch Paediatr Dent 2020; 22:111-119. [PMID: 33184697 DOI: 10.1007/s40368-020-00580-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/21/2020] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to systematically review the literature to answer the question: Are parental stress associated with early childhood caries (ECC)? METHODS Electronic databases including MEDLINE (via Pubmed), Scopus and SciELO were searched. Cross-sectional and case-control studies that investigate the association between parental stress and ECC were included. The Newcastle-Ottawa scale was used to assess the risk of bias of the included articles. RESULTS Out of 498 articles identified in initial research, 7 articles met the inclusion criteria; five were cross-sectional and two were control-case in design. A statistically significant correlation between ECC and total parental stress as well as a higher level of carious activity associated with total parental stress was reported in four studies. In two studies, no significant relationship between stress and ECC was found (P > 0.05) and in one study, parental stress was inversely associated with children's ECC status with better dental outcomes significantly associated with a higher level of parenting stress. CONCLUSION Despite the fact that the heterogenicity of the following data precluded conclusions to be drawn, it was obvious that parenting stress or some of its domains may influence the development of carious lesions in young children.
Collapse
Affiliation(s)
- F Chouchene
- Pediatric and Preventive Dentistry Department, Faculty of Dental Medicine of Monastir, ABCDF Laboratory of Biological, Clinical and Dento-Facial Approach, University of Monastir, Rue Hedi Chekir., 5111, Mahdia, Tunisia.
| | - F Masmoudi
- Pediatric and Preventive Dentistry Department, Faculty of Dental Medicine of Monastir, ABCDF Laboratory of Biological, Clinical and Dento-Facial Approach, Faculty of Dental Medicine of Monastir, Monastir, Tunisia
| | - A Baaziz
- Pediatric and Preventive Dentistry Department, Faculty of Dental Medicine of Monastir, ABCDF Laboratory of Biological, Clinical and Dento-Facial Approach, Faculty of Dental Medicine of Monastir, Monastir, Tunisia
| | - F Maatouk
- Pediatric and Preventive Dentistry Department, Faculty of Dental Medicine of Monastir, ABCDF Laboratory of Biological, Clinical and Dento-Facial Approach, Faculty of Dental Medicine of Monastir, Monastir, Tunisia
| | - H Ghedira
- Pediatric and Preventive Dentistry Department, Faculty of Dental Medicine of Monastir, ABCDF Laboratory of Biological, Clinical and Dento-Facial Approach, Faculty of Dental Medicine of Monastir, Monastir, Tunisia
| |
Collapse
|
20
|
Wattanarat O, Nirunsittirat A, Piwat S, Manmontri C, Teanpaisan R, Pahumunto N, Makeudom A, Sastraruji T, Krisanaprakornkit S. Significant elevation of salivary human neutrophil peptides 1-3 levels by probiotic milk in preschool children with severe early childhood caries: a randomized controlled trial. Clin Oral Investig 2020; 25:2891-2903. [PMID: 33001255 DOI: 10.1007/s00784-020-03606-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/23/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine salivary human neutrophil peptides 1-3 (HNP1-3) levels in caries-free preschool children and in those with early childhood caries (ECC) or severe-ECC, in a daily probiotic group, receiving reconstituted milk with the probiotic Lactobacillus paracasei SD1 once daily; a triweekly probiotic group, receiving the probiotic milk 3 days a week; and a placebo group. MATERIALS AND METHODS Oral examination and unstimulated whole saliva collection were conducted in 354 children at baseline, 6 months after intervention (T6), and after probiotic discontinuation (T12). Of the 354, adequate volume of saliva samples from 268 children were simultaneously analyzed for Streptococcus mutans and total lactobacilli levels using qPCR and for HNP1-3 levels using ELISA. RESULTS In the severe-ECC status, significant increases in the median HNP1-3 levels at T12 were found in both daily and triweekly probiotic groups (p < 0.001). The median S. mutans levels in the daily group were significantly decreased at T6 and T12 (p < 0.01), whereas the median total lactobacilli levels were significantly increased at T6 (p < 0.001). Significantly inverse correlations between altered HNP1-3 and S. mutans levels and significant decreases in caries progression were found in both probiotic groups (p < 0.05). CONCLUSIONS In the severe-ECC status, daily or triweekly consumption of L. paracasei SD1 significantly enhanced salivary HNP1-3 levels, but reduced S. mutans levels, possibly resulting in reduction of caries progression. CLINICAL RELEVANCE Significant enhancement of salivary HNP1-3 levels by probiotic consumption is associated with reduction in S. mutans levels, consistent with diminished caries progression in children with severe-ECC.
Collapse
Affiliation(s)
- Onnida Wattanarat
- Division of Pediatric Dentistry, Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand.,Center of Excellence in Oral and Maxillofacial Biology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Areerat Nirunsittirat
- Center of Excellence in Oral and Maxillofacial Biology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand.,Division of Community Dentistry, Department of Family and Community Dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Supatcharin Piwat
- Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Songkhla, 90112, Thailand.,Common Oral Diseases and Epidemiology Research Center, Faculty of Dentistry, Prince of Songkla University, Songkhla, 90112, Thailand
| | - Chanika Manmontri
- Division of Pediatric Dentistry, Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand.,Center of Excellence in Oral and Maxillofacial Biology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Rawee Teanpaisan
- Common Oral Diseases and Epidemiology Research Center, Faculty of Dentistry, Prince of Songkla University, Songkhla, 90112, Thailand.,Department of Stomatology, Faculty of Dentistry, Prince of Songkla University, Songkhla, 90112, Thailand
| | - Nuntiya Pahumunto
- Common Oral Diseases and Epidemiology Research Center, Faculty of Dentistry, Prince of Songkla University, Songkhla, 90112, Thailand.,Department of Stomatology, Faculty of Dentistry, Prince of Songkla University, Songkhla, 90112, Thailand
| | - Anupong Makeudom
- Center of Excellence in Oral and Maxillofacial Biology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Thanapat Sastraruji
- Center of Excellence in Oral and Maxillofacial Biology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Suttichai Krisanaprakornkit
- Center of Excellence in Oral and Maxillofacial Biology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand. .,Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand.
| |
Collapse
|
21
|
Luthfi M, Oki AS, Indrawati R, Rifai M, Dachlan YP, Razak FA. CD89/CD35 Expression Ratio in Salivary Neutrophil as an Early Detection Marker for Severe Early Childhood Caries. Eur J Dent 2020; 14:386-392. [PMID: 32645730 PMCID: PMC7440938 DOI: 10.1055/s-0040-1713704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives
To analyze CD35/CD89 expression ratio on the surface of neutrophils as an early detection marker for S-ECC.
Materials and Methods
Saliva was collected from 4- to 6-year-old kindergarten students. Salivary neutrophils were obtained by instructing the subjects to rinse their mouth with 1 mL of sterile 1.5% NaCl for 30 seconds before expectorating it into a sterile glass. The expression of CFSE
+
CD35
+
and CFSE
+
CD89
+
was measured and analyzed using flow cytometry.
Results
The expression of CFSE
+
CD89
+
in the caries-free group (2.46 ± 0.39) was significantly lower than that in the S-ECC group (3.41 ± 1.11), with a
p
-value of 0.0001, while the expression of CFSE
+
CD35
+
in the caries-free group was (2.35 ± 0.56) compared with (1.54 ± 0.35) (
p
= 0.0001) in the S-ECC group.
Conclusions
The expression ratio of CFSE
+
CD89
+
and CFSE
+
CD35
+
constitutes a marker for S-ECC.
Collapse
Affiliation(s)
- Muhammad Luthfi
- Department of Oral Biology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Aqsa Sjuhada Oki
- Department of Oral Biology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Retno Indrawati
- Department of Oral Biology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Muhaimin Rifai
- Department of Physiology, Cell Culture and Animal Development, Faculty of Sciences, Brawijaya University, Malang, Indonesia
| | - Yoes Prijatna Dachlan
- Department of Parasitology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Fathilah Abdul Razak
- Department of Oral and Craniofacial Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
22
|
Folayan MO, Alade M, Adeniyi A, El Tantawi M, Finlayson TL. Association between maternal socioeconomic factors, decision-making status, and dental utilization by children with early childhood caries in sub-urban Nigeria. J Public Health Dent 2020; 80:288-296. [PMID: 32633427 DOI: 10.1111/jphd.12383] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 04/15/2020] [Accepted: 05/31/2020] [Indexed: 11/28/2022]
Abstract
AIM To determine the association between maternal education, income, and decision-making status and the presence of early childhood caries (ECC) and dental-service utilization among young children. METHODS This cross-sectional study was based on data from a household survey of 1,549 mother-preschool-aged-child dyads conducted in Ife Central Local Government Area, Nigeria. The explanatory variables were maternal education, income, and decision-making status (related to healthcare, large household purchases, and visits to family/relatives). Outcome variables were the presence of ECC and the child's history of dental-service utilization. Poisson regression analyses were conducted to identify factors associated with outcomes; the models were adjusted for maternal age, child's socioeconomic status, oral hygiene status, and frequency of sugar consumption. RESULTS The study recruited 1,549 mother-child dyads, of which 66 (4.3 percent) children had ECC, and 90 (5.9 percent) children had a history of dental-service utilization. Fewer than half (42.3 percent) of the mothers earned between N18,001($49.00) and 60,000 ($168.00) per month. Also, 896 (57.8 percent) reported not making any independent decisions, 152 (9.8 percent) made one of three decisions independently, and 313 (20.2 percent) made two or three decisions independently. In the adjusted model, children of mothers with monthly income higher than N60,000 were more likely to have used dental services than were those whose mother's monthly income was less than or equal to N18,000 (adjusted prevalence ratio = 2.29; 95%CI: 1.30-4.02; P = 0.004). No other maternal factor was associated with ECC. CONCLUSIONS Although maternal socioeconomic factors and decision-making abilities were not associated with ECC prevalence, more preschool children whose mothers had high income used dental services.
Collapse
Affiliation(s)
- Morenike Oluwatoyin Folayan
- Department of Child Dental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun, Nigeria
| | - Micheal Alade
- Department of Child Dental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun, Nigeria
| | - Abiola Adeniyi
- Department of Child Dental Health, Lagos State University College of Medicine, Lagos, Nigeria
| | - Maha El Tantawi
- Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | | |
Collapse
|
23
|
Lee ZL, Gan WY, Lim PY, Hasan R, Lim SY. Associations of nutritional status, sugar and second-hand smoke exposure with dental caries among 3- to 6-year old Malaysian pre-schoolers: a cross-sectional study. BMC Oral Health 2020; 20:164. [PMID: 32493338 PMCID: PMC7268511 DOI: 10.1186/s12903-020-01152-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/27/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Dental caries in primary teeth is a serious oral health concern among children. It can lead to detrimental impacts on a child's growth, development, and quality of life. Therefore, this cross-sectional study aimed to examine the prevalence of dental caries and its associations with nutritional status, sugar and second-hand smoke exposure among pre-schoolers. METHODS A total of 26 pre-schools in Seremban, Malaysia were randomly selected using the probability proportional to size sampling. Dental examination was performed by a dentist to record the number of decayed teeth (dt). Weight and height of the pre-schoolers were measured. The mother-administered questionnaire was used to gather information pertaining to the sociodemographic characteristics and second-hand smoke exposure. Total sugar exposure was calculated from a 3-day food record. RESULTS Among the 396 participating pre-schoolers, 63.4% of them had at least one untreated caries, with a mean ± SD dt score of 3.56 ± 4.57. Negative binomial regression analysis revealed that being a boy (adjusted mean ratio = 1.42, 95% CI = 0.005-0.698, p = 0.047), exposed to second-hand smoke (adjusted mean ratio = 1.67, 95% CI = 0.168-0.857, p = 0.004) and those who had more than 6 times of daily total sugar exposure (adjusted mean ratio = 1.93, 95% CI = 0.138-0.857, p = 0.013) were significantly associated with dental caries among pre-schoolers. CONCLUSION A high prevalence of dental caries was reported in this study. This study highlights the need to reduce exposure to second-hand smoke and practice healthy eating behaviours in reducing the risk of dental caries among pre-schoolers.
Collapse
Affiliation(s)
- Zhi Ling Lee
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor Darul Ehsan, Malaysia
| | - Wan Ying Gan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor Darul Ehsan, Malaysia.
| | - Poh Ying Lim
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor Darul Ehsan, Malaysia
| | - Ruhaya Hasan
- School of Dental Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Sing Ying Lim
- Department of Paediatric Dental, Tuanku Ja'afar Hospital, Jalan Rasah, Bukit Rasah, 70300, Seremban, Negeri Sembilan, Malaysia
| |
Collapse
|
24
|
Kubota Y, San Pech N, Durward C, Ogawa H. Early childhood caries status and its associated factors among young children in a rural area of Cambodia. PEDIATRIC DENTAL JOURNAL 2020. [DOI: 10.1016/j.pdj.2019.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
25
|
Öcek ZA, Eden E, Yücel U, Çiçeklioglu M. Effects of an oral health program: Community-based education among mothers of young children living in socioeconomically disadvantaged neighborhoods. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:40. [PMID: 32318608 PMCID: PMC7161678 DOI: 10.4103/jehp.jehp_434_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 10/15/2019] [Indexed: 05/31/2023]
Abstract
INTRODUCTION An oral health program for mothers starting from pregnancy in a disadvantaged district of İzmir was performed in 2013-2016. Dental behaviors and their determinants among intervention and control groups were compared in the third phase of the program. METHODS This nonrandomized-controlled study was conducted in Phase 3. The intervention group began with 248 pregnant women; 69.4% (n = 172) of mothers with 6-9-month-old babies participated in Phase 2, 2014. At Phase 3 (18-24 months), 68.6% (n = 118) of mothers in the intervention group and 113 mothers living in another district as controls were included. Sociodemographic characteristics, determinants of behaviors, and outcomes defined as dental behaviors in the last week were assessed using a questionnaire. RESULTS Regarding knowledge, perceived severity, and fatalistic beliefs, the intervention group had higher correct answer percentages. The percentage of mothers who could clean their children's teeth before sleep was higher in the intervention group (76.3%; P < 0.05), but the difference was lost by a child's resistance. The significant difference on avoiding bedtime nursing (65.3%) and sugary snacks (74.4%) in the intervention group disappeared with the obstacle of a child's protests or interference from relatives. In the intervention group, 32.2% of the mothers reported that they did not give any sugary snacks, 43.2% had never fed during sleep, and 26.3% cleaned their children's teeth during the last week. The results in the control group were 24.8%, 18.6%, and 8.8%, respectively (P < 0.05). CONCLUSIONS The program improved the mothers' views regarding the determinants of dental behaviors, but greater support against obstacles was needed. Social environmental support is planned for the following stages of the program.
Collapse
Affiliation(s)
- Zeliha Asli Öcek
- Department of Public Health, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ece Eden
- Department of Pedodontics, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Ummahan Yücel
- Department of Midwifery, Faculty of Health Sciences, Ege University, Izmir, Turkey
| | - Meltem Çiçeklioglu
- Department of Public Health, Faculty of Medicine, Ege University, Izmir, Turkey
| |
Collapse
|
26
|
Riggs E, Kilpatrick N, Slack‐Smith L, Chadwick B, Yelland J, Muthu MS, Gomersall JC. Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries. Cochrane Database Syst Rev 2019; 2019:CD012155. [PMID: 31745970 PMCID: PMC6864402 DOI: 10.1002/14651858.cd012155.pub2] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Dental caries is one of the most common chronic diseases of childhood and is associated with adverse health and economic consequences for infants and their families. Socioeconomically disadvantaged children have a higher risk of early childhood caries (ECC). OBJECTIVES To assess the effects of interventions with pregnant women, new mothers or other primary caregivers of infants in the first year of life, for preventing ECC (from birth to six years of age). SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 14 January 2019), Cochrane Pregnancy and Childbirth Group's Trials Register (to 22 January 2019), Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Register of Studies, to 14 January 2019), MEDLINE Ovid (1946 to 14 January 2019), Embase Ovid (1980 to 14 January 2019) and CINAHL EBSCO (1937 to 14 January 2019). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on language or publication status. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing one or more interventions with pregnant women, mothers, or other caregivers of infants in the first year of life (intervention types included clinical, oral health education/promotion such as hygiene education, breastfeeding and other dietary advice, and policy or health service), versus standard care or placebo or another intervention. For inclusion, trials had to report at least one caries outcome. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial eligibility, extracted data, assessed risk of bias, and assessed certainty of evidence using the GRADE approach. MAIN RESULTS We included 17 RCTs (4 cluster-randomised), involving 23,732 caregivers (mainly mothers) and their children. Eleven RCTs assessed four oral health education/promotion interventions against standard care: child diet advice, child diet and feeding practice advice, breastfeeding promotion and support, and oral hygiene with child diet and feeding practice advice. Six trials assessed clinical interventions in mother's dentition, four trials chlorhexidine (CHX, a commonly prescribed antiseptic agent) or iodine-NaF application and prophylaxis versus placebo, and two trials xylitol against CHX or CHX + xylitol. At most, three trials (maximum of 1148 children and 130 mothers) contributed data to any comparison. For many trials, risk of bias was judged unclear due to lack of methodological details reported, and there was high risk of attrition bias in some trials. None of the included trials indicated receiving funding that is likely to have influenced their results. The trials were performed in high-, middle- and low-income countries. In nine trials, participants were socioeconomically disadvantaged. For child diet and feeding practice advice versus standard care, we observed a probable 15 per cent reduced risk of caries presence in primary teeth with the intervention (RR 0.85, 95% CI 0.75 to 0.97; 3 trials; 782 participants; moderate-certainty evidence), and there may be a lower mean dmfs (decayed, missing, filled primary surfaces) score (MD -0.29, 95% CI -0.58 to 0; 2 trials; 757 participants; low-certainty evidence); however, we are uncertain regarding the difference between the groups in mean dmft (decayed, missing, filled teeth) score (MD -0.90, 95% CI -1.85 to 0.05; 1 trial; 340 participants; very low-certainty evidence). For breastfeeding promotion and support versus standard care, we observed that there may be little or no a difference between groups in the risk of caries presence in primary teeth (RR 0.96, 95% CI 0.89 to 1.03; 2 trials; 1148 participants; low-certainty evidence), or mean dmft score (MD -0.12, 95% CI -0.59 to 0.36; 2 trials; 652 participants; low-certainty evidence). Dmfs was not reported for this comparison. We are uncertain whether child diet advice only compared with standard care reduces risk of caries presence in primary teeth (RR 1.08, 95% CI 0.34 to 3.37; 1 trial; 148 participants; very low-certainty evidence). Dmfs and dmft were not reported for this comparison. For oral hygiene, child diet and feeding practice advice versus standard care, we observed little or no reduced risk of caries presence in primary teeth (RR 0.91, 95% CI 0.75 to 1.10; 2 trials; 365 participants; low-certainty evidence), and are uncertain regarding difference between the groups in mean dmfs score (MD -0.99, 95% CI -2.45 to 0.47; 1 trial; 187 participants; very low-certainty evidence) and dmft score (MD -0.30, 95% CI -0.96 to 0.36; 1 trial; 187 participants; very low-certainty evidence). We observed there may be little or no difference in risk of caries presence in primary teeth between antimicrobial and placebo treatment in mother's dentition (RR 0.97, 95% CI 0.80 to 1.19; 3 trials; 479 participants; very low-certainty evidence). No trials assessing this comparison reported dmfs or dmft. For xylitol compared with CHX antimicrobial treatment, we observed there may be a lower mean dmft score with xylitol (MD -2.39; 95% CI -4.10 to -0.68; 1 trial, 113 participants; low-certainty evidence); however, we are uncertain regarding the difference between groups in caries presence in primary teeth (RR 0.62, 95% CI 0.27 to 1.39; 1 trial, 96 participants; very low-certainty evidence). Neither trial evaluating this comparison reported dmfs. No trials assessed a health policy or service intervention. AUTHORS' CONCLUSIONS Moderate-certainty evidence suggests that providing advice on diet and feeding to pregnant women, mothers or other caregivers with children up to the age of one year probably leads to a slightly reduced risk of early childhood caries (ECC). The remaining evidence is low to very low certainty and is insufficient for determining which, if any, other interventions types and features may be effective for preventing ECC. Large, high-quality RCTs of oral health education/promotion, clinical, and policy and service access interventions, are warranted to determine effects and relative effects of different interventions and inform practice. We have identified 12 studies currently in progress. Those designing future studies should describe the intervention components, setting and participants, consider if and how effects are modified by intervention features and participant characteristics, and adopt a consistent approach to measuring and reporting ECC.
Collapse
Affiliation(s)
- Elisha Riggs
- Murdoch Children's Research InstituteIntergenerational HealthFlemington RoadParkvilleVictoriaAustralia3052
- The University of MelbourneDepartment of General PracticeBerkeley StreetMelbourneVictoriaAustralia3000
| | - Nicky Kilpatrick
- Murdoch Children's Research InstituteVascular BiologyFlemington RoadParkvilleMelbourneVictoriaAustralia3052
- Royal Children's HospitalPlastic and Maxillofacial Surgery50 Flemington RoadParkvilleVictoriaAustralia3052
- The University of MelbourneDepartment of PaediatricsBerkeley StreetCarltonVictoriaAustralia3010
| | - Linda Slack‐Smith
- The University of Western AustraliaSchool of Population and Global Health35 Sterling Highway, CrawleyPerthWestern AustraliaAustralia6009
| | - Barbara Chadwick
- Cardiff UniversitySchool of DentistryHeath ParkCardiffUKCF14 4XY
| | - Jane Yelland
- Murdoch Children's Research InstituteIntergenerational HealthFlemington RoadParkvilleVictoriaAustralia3052
- The University of MelbourneDepartment of General PracticeBerkeley StreetMelbourneVictoriaAustralia3000
| | - M S Muthu
- Pedo Planet ‐ Children Dental CentersPediatric Dentistry161/62 A Mount Poonamallee RoadPorurChennaiIndia600116
- Sri Ramachandra Institute of Higher Education and ResearchCentre for Early Childhood Caries Research, Department of Pediatric and Preventive DentistryChennaiIndia
| | - Judith C Gomersall
- Women and Kids, South Australian Health and Medical Research InstituteWomen’s and Children’s Hospital7th Floor, 72 King William RoadAdelaideSouth AustraliaAustralia5006
- School of Public Health, University of AdelaideAdelaideAustralia
| | | |
Collapse
|
27
|
Samuel SR, Acharya S, Rao JC. School Interventions–based Prevention of Early‐Childhood Caries among 3–5‐year‐old children from very low socioeconomic status: Two‐year randomized trial. J Public Health Dent 2019; 80:51-60. [DOI: 10.1111/jphd.12348] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 06/17/2019] [Accepted: 09/13/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Srinivasan Raj Samuel
- Department of Public Health DentistrySaveetha Dental College, SIMATS Chennai Tamil Nadu India
| | - Shashidhar Acharya
- Department of Public Health Dentistry, Manipal College of Dental SciencesManipal University Manipal Karnataka India
| | - Jeevika Chandrasekar Rao
- Department of Public Health DentistryThai Moogambigai Dental College and Hospital, Dr. M.G.R Educational and Research Institute University Chennai Tamil Nadu India
| |
Collapse
|
28
|
Knoblauch U, Ritschel G, Weidner K, Mogwitz S, Hannig C, Viergutz G, Lenk M. The association between socioeconomic status, psychopathological symptom burden in mothers, and early childhood caries of their children. PLoS One 2019; 14:e0224509. [PMID: 31658278 PMCID: PMC6816547 DOI: 10.1371/journal.pone.0224509] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 10/15/2019] [Indexed: 12/31/2022] Open
Abstract
Objectives Various maternal mental disorders and socioeconomic status [SES] are discussed as risk factors for early childhood caries [ECC]. In our study, we examined a wide range of symptoms of mental disorders with the aim to identify those maternal psychopathological symptom burdens [PSBs] which show relevant associations with ECC. Our second objective was to investigate how SES affects the associations between PSB and ECC. Methods In this study, sixty children with ECC (caries group [CG]) and sixty caries-free children [NON-CG] with their mothers were recruited at two sites in Germany. Children aged three or four years were included in the study. Children’s dental status [dmf-t] and plaque index were recorded, and mothers answered a multidimensional SES index (including education, profession and income) as well as screening questionnaires capturing dental anxiety, depressive disorders, generalized anxiety, somatic symptom burden, eating disorders, traumatic childhood experiences, nicotine dependency and alcohol dependency. Results Mothers of the CG reported significantly higher dental anxiety (dCohen = 0.66), childhood trauma (dCohen = 0.53) and nicotine dependency (dCohen = 0.64) than the NON-CG. However, mediator analyses showed that these effects were partly mediated by the SES. Mothers of the CG had a significantly lower SES (dCohen = 0.93); with education as strongest predictor of dental status. The groups did not differ significantly in symptoms of depressiveness, subjective somatic symptom burden, alcohol dependency, eating disorders, and generalized anxiety. Conclusions Several PSBs are associated with ECC, however the SES as the strongest influencing factor mediates this association. Difficult socioeconomic conditions might predispose for both, ECC and mental illness. Targeted strategies are needed to facilitate the use of preventive measures and dental health services especially in families of lower status. For this purpose, psychosocial risk constellations must be identified. More integrative, multifactorial oriented research is necessary to gain a bio-psycho-social understanding of ECC.
Collapse
Affiliation(s)
- Uta Knoblauch
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Gerhard Ritschel
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Sabine Mogwitz
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christian Hannig
- Policlinic of Dental Maintenance, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Gabriele Viergutz
- Policlinic of Dental Maintenance, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Maria Lenk
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| |
Collapse
|
29
|
dos Santos Costa F, Agostini BA, Schuch HS, Britto Correa M, Goettems ML, Demarco FF. Parent-child interaction and stimulation in early life can be related to caries in primary dentition? Hypotheses from a life-course approach. Med Hypotheses 2019; 130:109291. [DOI: 10.1016/j.mehy.2019.109291] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 06/25/2019] [Indexed: 11/28/2022]
|
30
|
Htun KCSS, Peltzer K. Oral health-related quality of life among community dwelling middle-aged and older adults in an urban area in Magway region, Myanmar. NAGOYA JOURNAL OF MEDICAL SCIENCE 2019; 81:103-112. [PMID: 30962659 PMCID: PMC6433634 DOI: 10.18999/nagjms.81.1.103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
This study aims at describing oral health-related quality of life (OHRQoL) and determining its associated factors in a middle-aged and older adult community dwelling population in Myanmar. In a cross-sectional community survey, 633 individuals (men 55% and women 45%), aged 35–65 years, selected by multi-stage random sampling, responded to a structured questionnaire on the Oral Health Impact Profile-short form (OHIP-14), health status, health behavior and socio-demographic information. Participants had an overall mean score of 8.1(item mean=0.65) on the OHIP-14, 57.2% had impaired OHRQoL and 16.6% frequent impaired OHRQoL. The highest prevalence of problems was found to be psychological discomfort (60.2%), followed by physical pain (51.7%) and physical disability (40.9%). In adjusted logistic regression analysis, poor oral health status (tooth loss, having one or more cavities, and poor perceived periodontal health), and poor general health status (depressive symptoms) were positive while oral health behavior (drinking piped or bottled water, using toothpaste with fluoride, and never visited a dentist) were negatively associated with both impaired and frequent impaired OHRQoL. In addition, frequent soft drink consumption was associated with impaired OHRQoL, and having a high household income and being physically inactive were associated with frequent impaired OHRQoL. A high prevalence of impaired OHRQoL was found among this middle-aged and older adult population in central Myanmar. Several risk factors (poor oral health status, poor general health status, poor oral and general health behavior) for impaired OHRQoL were identified, which could help in guiding oral health interventions among the populace.
Collapse
Affiliation(s)
| | - Karl Peltzer
- Department for Management of Science and Technology Development, Ton Duc Thang University, Ho Chi Minh City, Vietnam.,Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| |
Collapse
|
31
|
Mansoori S, Mehta A, Ansari MI. Factors associated with Oral Health Related Quality of Life of children with severe -Early Childhood Caries. J Oral Biol Craniofac Res 2019; 9:222-225. [PMID: 31193595 DOI: 10.1016/j.jobcr.2019.05.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/27/2019] [Accepted: 05/17/2019] [Indexed: 11/30/2022] Open
Abstract
Background Early Childhood Caries (ECC) is a chronic childhood disease affecting children worldwide. Severe cases of ECC can significantly affect child's Oral Health Related Quality of Life (OHRQoL) owing to its consequences. The purpose of present study was to find out association between severe early childhood caries (s-ECC) and OHRQoL of children and their parents/care-givers visiting a Government dental hospital in Delhi, India. Methods Data was collected from a hospital - based sample of 454 child-parent pair. OHRQoL of the child and parent was assessed using the Hindi version of Early Childhood Oral Health Impact Scale (Hi-ECOHIS). Children with s-ECC were identified as per definition given by American Academy of Paediatric Dentistry. Chi square test and Binary regression analysis were used to evaluate the effect of s-ECC on OHRQoL and to study role of various socio demographic factors. Results The prevalence of s-ECC was 77.1% (n = 350).The mean dmft index score was 5.67 ( ±3.72) and dmfs was 11.21 ( ±11.03). The mean overall ECOHIS score was 7.02 ( ±5.47). Child impact items such as Pain, fever, caries associated swelling along with difficulty in eating food, halitosis, disturbed sleep, frequent absenteeism from school were found to be more significantly more frequent in children with s-ECC than ECC. Children with bottle-feeding habit of more than one year, having fewer siblings, and whose parents belong to upper socio economic class were at higher odds of suffering from s-ECC.Conclusion: s-ECC has significantly more detrimental impact on the OHRQoL of children and their parents in comparison to ECC.
Collapse
Affiliation(s)
- Shahnaz Mansoori
- Department of Pediatric and Preventive Dentistry, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Abhishek Mehta
- Department of Public Health Dentistry, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Mohd Irfan Ansari
- Department of Conservative and Endodontics, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| |
Collapse
|
32
|
Almoudi MM, Hussein AS, Abu Hassan MI, Schroth RJ. Dental caries and vitamin D status in children in Asia. Pediatr Int 2019; 61:327-338. [PMID: 30740822 DOI: 10.1111/ped.13801] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 11/24/2018] [Accepted: 02/07/2019] [Indexed: 12/12/2022]
Abstract
Dental caries and vitamin D inadequacy are known to affect children worldwide. Vitamin D has a vital role in tooth formation. There is growing evidence linking suboptimal serum vitamin D level with dental caries in children. This paper reviews the literature on both the prevalence of dental caries and of vitamin D deficiency in children in four Asian regions, discusses their associated risk factors, and reviews the global evidence on the association between dental caries and vitamin D in children. Caries prevalence in children ranged from 40% to 97% in Eastern Asia, 38-73.7% in Southern Asia, and 26.5-74.7% in Western Asian countries. Moreover, a higher prevalence of vitamin D deficiency in Asian children was identified, even in countries in equatorial regions, ranging from 2.8% to 65.3% in Eastern Asia, 5-66.7% in Southern Asia, 4-45.5% in Western Asia and 38.1-78.7% in Central Asian countries. Obesity, age, female gender, higher latitude, season, darker skin pigmentation, sunlight protection behaviors, less sunlight exposure and low intake of food containing vitamin D were important factors associated with lower serum vitamin D in Asia. Suboptimal vitamin D level in children may be a significant risk factor for dental caries, and requires further research to ascertain such an association in children in Asia, as well as to understand its exact influence on caries risk and development.
Collapse
Affiliation(s)
- Manal Mohamed Almoudi
- Centre of Paediatric Dentistry and Orthodontics Studies, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia
| | - Alaa Sabah Hussein
- Centre of Paediatric Dentistry and Orthodontics Studies, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia
| | - Mohamed Ibrahim Abu Hassan
- Centre of Restorative Dentistry Studies, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia
| | - Robert J Schroth
- Department of Preventive Dental Science, College of Dentistry, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Pediatrics and Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| |
Collapse
|
33
|
Kirthiga M, Murugan M, Saikia A, Kirubakaran R. Risk Factors for Early Childhood Caries: A Systematic Review and Meta-Analysis of Case Control and Cohort Studies. Pediatr Dent 2019; 41:95-112. [PMID: 30992106 PMCID: PMC7100045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose: The purpose of this study was to perform a systematic review to assess current evidence for association between various risk factors and the prevalence or incidence of early childhood caries (ECC). Methods: Two reviewers searched various databases until January 2019. The Newcastle-Ottawa scale was used to perform risk of bias assessment. The included studies were categorized according to the World Bank classification. Data were summarized in a meta-analysis using fixed and random effects inverse-generic meta-analyses. Results: A total of 7,034 records involving 89 studies that evaluated 1,352,097 individuals were included; 23 were high, 46 were moderate, and 20 were of low quality. A total of 123 risk factors were found. Meta-analysis revealed that the strongest risk factors found in the high-income countries were presence of dentinal caries (dmft greater than zero; odds ratio [OR] equals 4.21 [2.18 to 8.16]) and high levels of mutans streptococci (OR equals 3.83 [1.81 to 8.09]). In upper-middle-income countries, presence of enamel defects (OR equals 14.62 [6.10 to 35.03]) was found to be the strongest risk factor. Conclusion: The strongest risk factors associated with early childhood caries was the presence of enamel defects, presence of dentinal caries and high levels of mutans streptococci.
Collapse
Affiliation(s)
- M Kirthiga
- Dr. M is an Early Career Research fellow (Wellcome Trust DBT India Alliance), Department of Pedodontics and Preventive Dentistry, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu
| | - Muthu Murugan
- Dr. Murugan is Head of Center for Early Childhood Caries Research (CECCRe), Department of Pedodontics and Preventive Dentistry, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu;,
| | - Ankita Saikia
- Dr. Saikia is a pediatric dental surgeon, Pedo Planet - Children's Dental Centre, Chennai
| | - Richard Kirubakaran
- Dr. Kirubakaran is a biostatistician, South Asian Cochrane Network and Centre, Christian Medical College, Vellore, Tamil Nadu
| |
Collapse
|
34
|
Homecare protective and risk factors for early childhood caries in Japan. Environ Health Prev Med 2018; 23:57. [PMID: 30400771 PMCID: PMC6220465 DOI: 10.1186/s12199-018-0746-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 10/19/2018] [Indexed: 11/10/2022] Open
Abstract
Background Early childhood caries (ECC) affects children across Japan and throughout the world. Thus, it is important to identify dietary and dental care habits that either promote oral health or cause ECC. The objective of this study was to identify protective and risk factors associated with ECC in Japan. Methods In a typical rural Japanese community, we selected children born between 2004 and 2008 who had received checkups at their community health center including oral examinations conducted by dentists. We obtained data from children’s records and from a questionnaire filled out by parents. We enrolled only children who at their checkup for 18-month-olds had no caries, and we obtained data about them at their checkup for 3-year-olds. We classified children as either having caries (treated or untreated) or being caries-free. We conducted bivariate analyses using data on child/family demographic characteristics, child’s dietary habits, and child/parental oral health habits. We also conducted logistic regression analysis to control for variables and identify predictors of the presence/absence of caries. Results Five hundred sixty six children (278 boys, 288 girls) were enrolled and followed. After 2 years, 173 children (30.6%) presented with caries. Logistic regression analysis predicting caries at follow-up identified the interaction term “bottlefed overnight and brushed irregularly” at 18 months of age as a highly significant predictor of developing caries—adjusted odds ratio (AOR) of 14.27, 95% confidence interval (CI) 1.02–199.71. Two variables measured at follow-up were also significant predictors: having low levels of dental plaque (AOR 2.41, 95% CI 1.34–4.35) and having a mother who had untreated caries (AOR 1.84, 95% CI 1.09–3.12). Conclusion Public health efforts should encourage parents to eliminate bottle feeding overnight and promote brushing twice daily as children’s teeth begin to erupt. Greater efforts should be made to teach parents and daytime caregivers how to brush effectively to remove all plaque. Health professionals should pay close attention to mothers’ oral health status. Mothers with caries should receive prompt treatment and be assisted in developing better dietary and oral health habits that will benefit themselves and their children. Policies and programs should focus more on family oral health rather than just child oral health.
Collapse
|
35
|
Gavic L, Tadin A, Mihanovic I, Gorseta K, Cigic L. The role of parental anxiety, depression, and psychological stress level on the development of early-childhood caries in children. Int J Paediatr Dent 2018; 28:616-623. [PMID: 30144198 DOI: 10.1111/ipd.12419] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/14/2018] [Accepted: 07/08/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND It is important to understand how the psychological status of parents affects oral health in children. AIM This study aimed to assess the level of depression, anxiety, and stress of parents whose children have early-childhood caries. DESIGN The study included 235 children and their parents who visited the Dental clinic at the School of Medicine of the University of Split between October 2016 and July 2017. The dental status of each child was recorded, while parents filled out the Depression Anxiety Stress Scale questionnaire and the questionnaire related to the demographic characteristics, questions related to child's habits of the tooth brushing, eating sweets. RESULTS Multiple regression analysis showed that the incidence of active caries in the children was statistically significantly related not only to the level of parent depression (β = -0.289; P = 0.040) but also the level of anxiety (β = 0.186; P = 0.038) and stress (β = -0.120; P = 0.036). The dmft index in the examined children was negatively significant associated with the parental level of depression (β = -0.305; P = 0.032). CONCLUSION Considering the results of our research it is essential to emphasize the need for better health education of parents.
Collapse
Affiliation(s)
- Lidia Gavic
- Study of Dental Medicine, School of Medicine, University of Split, Split, Croatia
| | - Antonija Tadin
- Study of Dental Medicine, School of Medicine, University of Split, Split, Croatia
| | - Ina Mihanovic
- Study of Dental Medicine, School of Medicine, University of Split, Split, Croatia
| | - Kristina Gorseta
- Department of Paediatric Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Livia Cigic
- Study of Dental Medicine, School of Medicine, University of Split, Split, Croatia
| |
Collapse
|
36
|
Ha DH, Do LG. Early Life Professional and Layperson Support Reduce Poor Oral Hygiene Habits in Toddlers-A Prospective Birth Cohort Study. Dent J (Basel) 2018; 6:dj6040056. [PMID: 30297678 PMCID: PMC6313388 DOI: 10.3390/dj6040056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 10/02/2018] [Accepted: 10/05/2018] [Indexed: 11/16/2022] Open
Abstract
Oral health behaviours of children are formulated from a very young age. Formation of those behaviours among very young children is dependent on their mothers/caregivers who may themselves require support from the health profession or laypersons. The study aimed to investigate if early life visits for check-up and dental advice and perceived support improved oral health behaviours as practiced by mothers of toddlers aged 24–30 months old. Data from a population-base birth cohort study in South Australia was used. The study recruited and followed mothers of newborn children from birth to age 24–30 months. Parental questionnaires collected information about socioeconomic factors, dental visiting patterns, and oral health behaviours as practiced by the mothers for their child. Self-reported putting a child to bed with a bottle and brushing a child’s teeth were the outcome variables. The two main exposures of this study were (1) early visiting for a dental advice, and (2) layperson support that a mother received in the first two years of having the child. Data were analysed progressively from bivariate to multivariable regression models. A total of 1183 mother/child dyads had complete data. The retained sample was representative of the population. Approximately 36% of mothers put their child to bed with a bottle and 26% of mothers did not brush their child’s teeth the night before. Around 29% of children had a visit for dental check-up and 80% of mothers reported having lay support. There were gradients in the outcome variables by socioeconomic factors and the main exposures. Multivariable regression models reported that having no dental visit for advice and having no lay support were associated with 1.30 and 1.21 imes higher rates of putting a child to bed with a bottle, respectively. Having no dental visit for advice was associated with a 1.37-times higher rate of not brushing a child’s teeth, controlling for other factors. This population-based birth cohort study confirmed importance of early life dental visit for check-up and support for mothers of young children in establishing oral health behaviours of young children.
Collapse
Affiliation(s)
- Diep Hong Ha
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide 5005, Australia.
| | - Loc Giang Do
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide 5005, Australia.
| |
Collapse
|
37
|
Frencken JE, Sharma P, Stenhouse L, Green D, Laverty D, Dietrich T. Global epidemiology of dental caries and severe periodontitis - a comprehensive review. J Clin Periodontol 2018; 44 Suppl 18:S94-S105. [PMID: 28266116 DOI: 10.1111/jcpe.12677] [Citation(s) in RCA: 497] [Impact Index Per Article: 82.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND Dental caries and periodontitis are the most common oral diseases and major causes of tooth loss. AIM To perform a review of global prevalence and incidence of dental caries and periodontitis. METHODOLOGY Inclusion and exclusion criteria were developed. MEDLINE database and EMBASE database were used to search for eligible publications using keywords and MeSH terms. Additionally, WHO databank was used for obtaining dental caries information and PUBMED for a search on trends of dental caries prevalence and severity. RESULTS Over the last four decades, the prevalence and severity of dentine carious lesions among 5- and 12-year-olds have declined; the decay-component is very high, with the lowest prevalence among 12-year-olds in high-income countries, which also had the lowest prevalence among 35- to 44-year-olds; and the number of retained teeth has increased around the globe. The prevalence of periodontitis is high, with approximately 10% of the global population affected by severe periodontitis. Study heterogeneity and methodological issues hamper comparisons across studies and over time. CONCLUSION While the prevalence of dental caries has decreased, the disease is prevalent in all age groups. The prevalence of periodontitis is high. There is insufficient evidence to conclude that the prevalence of periodontitis has changed over time.
Collapse
Affiliation(s)
- Jo E Frencken
- Department of Oral Function and Prosthetic Dentistry, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Praveen Sharma
- Periodontal Research Group, College of Medical and Dental Sciences, Dental School, University of Birmingham, Birmingham, UK
| | - Laura Stenhouse
- Department of Special Care Dentistry, Birmingham Dental Hospital and School of Dentistry, Birmingham, UK
| | - David Green
- Department of Restorative Dentistry, Birmingham Dental Hospital and School of Dentistry, Birmingham, UK
| | - Dominic Laverty
- Department of Restorative Dentistry, Birmingham Dental Hospital and School of Dentistry, Birmingham, UK
| | - Thomas Dietrich
- Periodontal Research Group, College of Medical and Dental Sciences, Dental School, University of Birmingham, Birmingham, UK
| |
Collapse
|
38
|
Rai NK, Tiwari T. Parental Factors Influencing the Development of Early Childhood Caries in Developing Nations: A Systematic Review. Front Public Health 2018; 6:64. [PMID: 29616206 PMCID: PMC5865069 DOI: 10.3389/fpubh.2018.00064] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 02/16/2018] [Indexed: 10/31/2022] Open
Abstract
Background Early childhood caries (ECC) is one of the most prevalent and chronic conditions of childhood. Various factors including biological and dietary factors along with an overlay of parental social factors have been found to be associated with the progression of ECC. The objective of this systematic review is to synthesize available literature and to identify parent-level proximal and distal risk factors associated with the development of ECC in developing nations. Methods Studies conducted in developing nations, published between 2005 and 2017 in English, that included children younger than 6 years and examined ECC were included. The outcome of interest were parental risk factors, which included parental knowledge, behavior, attitudes, sense of coherence (SOC), stress, socioeconomic status (SES), education, and breastfeeding duration. The studies were retrieved from MEDLINE, Ovid Medline, and PubMed. Results The search yielded 325 studies, of which 18 were considered eligible for inclusion in this review. Ten studies found maternal education, and seven studies found parental education to be significantly associated with ECC. SES was significantly associated with ECC in 13 studies in the form of annual household income and occupation level. Four studies observed the significant association between oral health knowledge and attitudes with ECC, whereas only two studies found maternal attitude to be associated with ECC. Breastfeeding duration was a significant risk factor in four studies. One study each found significant associations of SOC, parental distress, and secondary smoke with ECC. Conclusion To date, most of the researches done in developing countries have reported distal parental factors such as income and education being significant risk factors in caries development compared to proximal risk factors in low-income groups. Only a few studies analyzed the psychosocial and behavioral factors. Interventions could be designed to improve parental oral health knowledge and behaviors in these nations.
Collapse
Affiliation(s)
- Nayanjot Kaur Rai
- School of Dental Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Tamanna Tiwari
- School of Dental Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| |
Collapse
|
39
|
Li Y, Wulaerhan J, Liu Y, Abudureyimu A, Zhao J. Prevalence of severe early childhood caries and associated socioeconomic and behavioral factors in Xinjiang, China: a cross-sectional study. BMC Oral Health 2017; 17:144. [PMID: 29197365 PMCID: PMC5712104 DOI: 10.1186/s12903-017-0432-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 11/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study assessed the prevalence and severity of early childhood caries (ECC) and identified socioeconomic and behavioral correlates of the disease in preschool children living in Xinjiang. METHODS For this cross-sectional survey, 1727 children aged 3-5 years in Xinjiang were randomly recruited using a three-stage cluster sampling procedure. The "dmft" index according to the WHO 1997 criteria was used to assess ECC and severe ECC (S-ECC). A questionnaire was completed by caregivers. Variables included sociodemographic characteristics, dietary and oral hygiene behaviors, and access to dental services. The statistical associations of variables with ECC, S-ECC, and dmft were evaluated by univariate and multiple logistic regression analyses. RESULTS The prevalence of ECC was 78.2% and that of S-ECC was 41.2%; mean dmft scores were 5.61 ± 3.56 and 8.17 ± 2.94, respectively. The prevalence of ECC was significantly higher in children from Ining (OR 2.747; 95% CI 2.033-3.713), those whose caregivers had caries (OR 1.78; 95% CI 1.245-2.547), those with a dental visit in the past (OR 2.023; 95% CI 1.429-2.865), and those whose parents had received instructions on oral health care (OR 2.171; 95% CI 1.44-3.272), and increased significantly at age 4 years (OR 2.09; 95% CI 1.506-2.901) and 5 years (OR 2.666; 95% CI 1.855-3.833) and in children who starting tooth brushing at a young age (OR 1.363; 95% CI 1.171-1.587), and decreased significantly in children with a more educated mother (OR 0.817; 95% CI 0.688-1), those from high-income families (OR 0.667; 95% CI 0.582-0.765), those with low consumption of sweets (OR 0.66; 95% CI 0.57-0.763), and those who seldom ate before sleep (OR 0.557; 95% CI 0.437-0.712). CONCLUSIONS ECC and S-ECC remain a serious problem among preschool children in Xinjiang. Caries rates were associated with sociodemographic and behavioral factors, which could be modified by public health strategies, including protection of primary dentition, extension of insurance to cover oral preventive services, improvement of the oral health care system, and public health education.
Collapse
Affiliation(s)
- Yan Li
- Department of Endodontics, the First Affiliated Hospital of Xinjiang Medical University, No. 137, Li Yu Shan South Road, Urumqi, Xinjiang Province, 830054, China
| | - Jibieke Wulaerhan
- Stomatology Disease Institute of Xinjiang Uyghur Autonomous Region, Urumqi, Xinjiang, 830054, China
| | - Yuan Liu
- Department of Endodontics, the First Affiliated Hospital of Xinjiang Medical University, No. 137, Li Yu Shan South Road, Urumqi, Xinjiang Province, 830054, China
| | - Ayinuer Abudureyimu
- Stomatology Disease Institute of Xinjiang Uyghur Autonomous Region, Urumqi, Xinjiang, 830054, China
| | - Jin Zhao
- Department of Endodontics, the First Affiliated Hospital of Xinjiang Medical University, No. 137, Li Yu Shan South Road, Urumqi, Xinjiang Province, 830054, China.
| |
Collapse
|
40
|
Basir L, Rasteh B, Montazeri A, Araban M. Four-level evaluation of health promotion intervention for preventing early childhood caries: a randomized controlled trial. BMC Public Health 2017; 17:767. [PMID: 28969655 PMCID: PMC5625785 DOI: 10.1186/s12889-017-4783-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 09/21/2017] [Indexed: 11/12/2022] Open
Abstract
Background Early childhood caries (ECC) is the most common dental disease among children, which can affect children’s primary teeth during their teething. This study evaluates an intervention for preventing early childhood caries in a pediatric population in Ahvaz, Iran. Method The population of this study (IRCT2017070210804N10) consists of 104 women with 12 to 36 months of age without dental caries referred to a health care center in Ahvaz, Iran. The children were randomly assigned to either an experimental or control group in equal numbers. First, the demographic information of participants was collected through a questionnaire containing components of perceived threat, health literacy, and oral health behaviors using a valid and reliable questionnaire. The ECC status of the children was established by a dentist. Control group received “standard well baby care”. The experimental group received standard well baby care in addition to educational interventions, including lecture and group discussion. After 6 months, the participant completed the questionnaire for the second time, and the children’s teeth were reexamined. Data were analyzed using SPSS version 15 at a significance level of p < 0.05. Results The mean ages of women and children were 31 ± 6.68 years and 18 ± 7.21 months, respectively. Before the intervention, no significant difference was documented between the groups for the study variables, p > 0.05. However, after the intervention, a significant difference was observed between the perceived threats (41.15 ± 4.46 in the experimental group and 38.26 ± 4.21 in the control group, p = 0.001), health literacy (20.98 ± 2.15 in the experimental group and 19.76 ± 2.70 in the control group, p = 0.01), oral health behaviors (7.75 ± 2.30 in the experimental group and 6.15 ± 2.65 in the control group, p = 0.01), and the incidence of ECC (13% in the experimental group and 35% in the control group,p = 0.001). Conclusion This intervention had positive effects on the perceived threat, health literacy, and health behaviors; and the intervention could reduce the incidence of ECC. The finding of this study provided a suggestion for evidence-based decision-making processes regarding ECCs prevention programs. Trial registration IRCT2017070210804N10 (retrospectively registered)
Collapse
Affiliation(s)
- Leila Basir
- Department of Pediatric Dentistry, School of dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bita Rasteh
- School of dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Montazeri
- Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Marzieh Araban
- Social Determinants of Health Research center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. .,Department of Health Education and Promotion, Public Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| |
Collapse
|
41
|
Stephen A, Krishnan R, Chalakkal P. The Association between Cariogenic Factors and the Occurrence of Early Childhood Caries in Children from Salem District of India. J Clin Diagn Res 2017; 11:ZC63-ZC66. [PMID: 28893046 DOI: 10.7860/jcdr/2017/25574.10217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 05/03/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Various aetiological factors for Early Childhood Caries (ECC) have been suggested in literature, but the role of each factor has been disputed in various studies. AIM To evaluate the association between ECC and its related factors in children between three to six years of age, from rural, semi-urban and urban schools in the district of Salem (India). MATERIALS AND METHODS The study consisted of children between three to six years of age, selected randomly from schools in semi-urban, urban and rural schools at Salem. Questionnaire (comprising of the factors associated with ECC) and parental consent forms were sent to each of the parents of the school children. Filled questionnaires and parental consent forms were obtained from a total of 2771 children, out of which 1771 were boys and 1000 were girls. Clinical examination for ECC was carried out according to the WHO criteria, by a single examiner and an assistant to eliminate inter-examiner variability. Statistical analysis was carried out using the student's independent t-test and ANOVA (one way analysis of variance). RESULTS Out of a total of 2771 children examined, only 443 (315 boys and 128 girls) children were found to have ECC (16 %). Significant correlations were found between the occurrence of ECC and various factors like age of parents, number of siblings, on-demand breast feeding and bottle feeding habits and sweetened pacifier use. However, factors such as age and gender of the child, type of birth and duration of pregnancy, had no significant correlation with the occurrence of ECC. CONCLUSION The need for educating parents on the ill effects of improper breast feeding and bottle feeding habits is important.
Collapse
Affiliation(s)
- Arokiaraj Stephen
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Vinayaka Missions Sankarachariar Dental College, Salem, Tamil Nadu, India
| | - Ramesh Krishnan
- Professor, Department of Pedodontics and Preventive Dentistry, Vinayaka Missions Sankarachariar Dental College, Salem, Tamil Nadu, India
| | - Paul Chalakkal
- Assistant Professor, Department of Pedodontics and Preventive Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
| |
Collapse
|
42
|
Wang X, Wei Z, Li Q, Mei L. A longitudinal study of early childhood caries incidence in Wenzhou preschool children. BMC Oral Health 2017; 17:105. [PMID: 28676047 PMCID: PMC5496385 DOI: 10.1186/s12903-017-0394-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 06/19/2017] [Indexed: 12/03/2022] Open
Abstract
Background Early childhood caries (ECC) is a serious public health problem in China. Few studies, however, have described the incidence of ECC in China. The purpose of this study was to assess the prevalence and incidence of ECC among preschool children in Wenzhou China. Methods Preschool children aged 3–4 years old were surveyed and followed up when they reached 5–6 years of age in the city of Wenzhou in southeast China. The rates of dental caries were determined with prevalence, and incidence density for risk of caries of a person (IDp) and of a tooth surface (IDs). Results The prevalence and decayed, missing, and filled primary teeth (dmft) score of 3–4, 4–5, and 5-6 years old children were 59.8% and 2.9, 71.8% and 4.2, and 76.4% and 4.6, respectively. The IDp was 29.7 and 14.8 persons/100 person-year during the first and second year. The IDs was 5.9 and 2.7 newly affected surfaces/100 surface-year, respectively. The percentage of molars with caries experience increased obviously; the percentage of maxillary central incisors and mandibular incisors with caries experience increased during the first follow-up, whereas it declined during the second follow-up; the others increased gradually. Conclusions The prevalence and incidence of dental caries in Wenzhou preschool children were very high with most of the carious teeth left untreated. The molars were the most affected teeth during the observation period.
Collapse
Affiliation(s)
- Xiping Wang
- Department of Preventive and Pediatric Dentistry, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China
| | - Zhiyuan Wei
- Department of Preventive and Pediatric Dentistry, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China
| | - Qiao Li
- Department of Preventive and Pediatric Dentistry, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China
| | - Liqin Mei
- Department of Preventive and Pediatric Dentistry, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China.
| |
Collapse
|
43
|
Javed F, Feng C, Kopycka-Kedzierawski DT. Incidence of early childhood caries: A systematic review and meta-analysis. ACTA ACUST UNITED AC 2016; 8. [DOI: 10.1111/jicd.12238] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 08/11/2016] [Indexed: 01/12/2023]
Affiliation(s)
- Fawad Javed
- Department of General Dentistry; Eastman Institute for Oral Health; University of Rochester; Rochester NY USA
| | - Changyong Feng
- Department of Biostatistics and Computational Biology; University of Rochester; Rochester NY USA
| | - Dorota T. Kopycka-Kedzierawski
- Division of Community Dentistry and Oral Disease Prevention; Eastman Institute for Oral Health; University of Rochester; Rochester NY USA
| |
Collapse
|
44
|
Collins CC, Villa-Torres L, Sams LD, Zeldin LP, Divaris K. Framing Young Childrens Oral Health: A Participatory Action Research Project. PLoS One 2016; 11:e0161728. [PMID: 27548714 PMCID: PMC4993516 DOI: 10.1371/journal.pone.0161728] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 08/10/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Despite the widespread acknowledgement of the importance of childhood oral health, little progress has been made in preventing early childhood caries. Limited information exists regarding specific daily-life and community-related factors that impede optimal oral hygiene, diet, care, and ultimately oral health for children. We sought to understand what parents of young children consider important and potentially modifiable factors and resources influencing their children's oral health, within the contexts of the family and the community. METHODS This qualitative study employed Photovoice among 10 English-speaking parents of infants and toddlers who were clients of an urban WIC clinic in North Carolina. The primary research question was: "What do you consider as important behaviors, as well as family and community resources to prevent cavities among young children?" Five group sessions were conducted and they were recorded, transcribed verbatim and analyzed using qualitative research methodology. Inductive analyses were based on analytical summaries, double-coding, and summary matrices and were done using Atlas.ti.7.5.9 software. FINDINGS Good oral health was associated with avoidance of problems or restorations for the participants. Financial constraints affected healthy food and beverage choices, as well as access to oral health care. Time constraints and occasional frustration related to children's oral hygiene emerged as additional barriers. Establishment of rules/routines and commitment to them was a successful strategy to promote their children's oral health, as well as modeling of older siblings, cooperation among caregivers and peer support. Community programs and organizations, social hubs including playgrounds, grocery stores and social media emerged as promising avenues for gaining support and sharing resources. CONCLUSIONS Low-income parents of young children are faced with daily life struggles that interfere with oral health and care. Financial constraints are pervasive, but parents identified several strategies involving home care and community agents that can be helpful. Future interventions aimed to improve children's oral health must take into consideration the role of families and the communities in which they live.
Collapse
Affiliation(s)
- Chimere C. Collins
- Department of Dental Ecology, School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States of America
| | - Laura Villa-Torres
- Department of Health Behavior, UNC Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States of America
| | - Lattice D. Sams
- Department of Dental Ecology, School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States of America
| | - Leslie P. Zeldin
- Oral and Craniofacial Health Sciences, School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States of America
| | - Kimon Divaris
- Department of Pediatric Dentistry, School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States of America
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States of America
- * E-mail:
| |
Collapse
|
45
|
Riggs E, Slack-Smith L, Yelland J, Chadwick B, Robertson L, Kilpatrick N. Interventions with pregnant women and new mothers for preventing caries in children. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2016. [DOI: 10.1002/14651858.cd012155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Elisha Riggs
- Murdoch Childrens Research Institute; Healthy Mothers Healthy Families Research Group; Flemington Road Parkville Victoria Australia 3052
- University of Melbourne; General Practice and Primary Health Care Academic Centre; Parkville Victoria Australia
| | - Linda Slack-Smith
- University of Western Australia; School of Dentistry; 35 Sterling Highway, Crawley Perth Western Australia Australia 6009
| | - Jane Yelland
- Murdoch Childrens Research Institute; Healthy Mothers Healthy Families Research Group; Flemington Road Parkville Victoria Australia 3052
- University of Melbourne; General Practice and Primary Health Care Academic Centre; Parkville Victoria Australia
| | - Barbara Chadwick
- Cardiff University; School of Dentistry; Heath Park Cardiff UK CF14 4XY
| | - Louise Robertson
- Murdoch Childrens Research Institute; Healthy Mothers Healthy Families Research Group; Flemington Road Parkville Victoria Australia 3052
| | - Nicky Kilpatrick
- Murdoch Childrens Research Institute; Vascular Biology; Flemington Road Parkville Melbourne Victoria Australia 3052
- University of Melbourne; Department of Paediatrics; Parkville Victoria Australia
| |
Collapse
|